Organization
UNIVERSITY SURGEONS OF ORANGE A MEDICAL GROUP
Active
Other names
Regents of the University of California, University Surgeons of Orange
Organization subpart
No
Provider details
NPI number
Authorized official
SYLVIA COPEN (PROVIDER ENROLLMENT MANAGER)
(714) 456-6227
Entity
Organization
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868
(714) 456-7212
(714) 456-7601
Mailing address
PO BOX 31001-2446, PASADENA, CA 91110-2446
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
—
—
208600000X
Surgery Physician
Primary
—
—
2086S0102X
Surgical Critical Care Physician
—
—
2086S0120X
Pediatric Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0052890
MEDI-CAL GROUP #
CA
01
—
ZZZ54068Z
BLUE SHIELD GROUP #
CA
01
—
ZZZ54072Z
BLUE SHIELD GROUP #
CA
01
—
ZZZ54074Z
BLUE SHIELD GROUP #
CA
01
—
ZZZ54076Z
BLUE SHIELD GROUP #
CA
01
—
ZZZ54079Z
BLUE SHIELD GROUP #
CA
01
—
ZZZ54264Z
BLUE SHIELD GROUP #
CA
Enumeration date
05/12/2006
Last updated
05/22/2025
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